**4.2 Drugs that indirectly ameliorate the effects/symptoms of COVID-19 disease through direct influence on cellular immunity and metabolism**

This group of drugs acts by completely different mechanisms as they do not share structural similarities. Some of them include dapaglifozin, leflunomide, plitidepsin, nitazoxanide. Nitazoxanide demonstrates broad-spectrum antiviral action against several viral diseases. Nitazoxanide showed good in-vitro activity against SARS-CoV-2 in cell culture experiments, showing potential for repurposing in COVID-19 [41]. Nitazoxanide has shown great promise in vitro, with a low IC50 against SARS-CoV-2. Nitazoxanide phosphorylates protein kinases activated by dsRNA to increase phosphorylated kinases activated by dsRNA to increase phosphorylated factor 2α. Factor 2α is an intracellular protein possessing antiviral activities [28]. Despite the potential effectiveness of these drugs, further in vivo and clinical testing are required.
